“When people go to Tijuana, they usually come looking for cheap places, and cheap places do not follow the rules,” said Dr. Benjamin Talei, a Beverly Hills plastic surgeon, according to NBC Los Angeles.

It’s tough to treat the drug-resistant infections, which the CDC said are rare in the United States. The result can be deadly.

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Dr. David Ham, a CDC medical officer, said 11 cases are confirmed — nine of which happened from August to November 2018, one is still being investigated and another occurred in 2015, CNN reports.

Most of the U.S. visitors to the Mexican city, which is just across the border with California, sought weight-loss surgery, the CDC reported. Roughly half caught the infection while under the knife at Grand View Hospital. According to the CDC, the Mexican government has since closed the hospital.

“Patients in hospitals, especially those on breathing machines, those with devices such as catheters, and patients with wounds from surgery or from burns are potentially at risk for serious, life-threatening infections,” according to the CDC.

But Pseudomonas aeruginosa bacteria infections can also spread through poorly cleaned equipment, and from healthcare workers to patients, the CDC warns.

Each year about 51,000 infections of the bacteria occur in U.S. medical settings alone — and around 13 percent of those are drug-resistant, according to the CDC. The infections kill 400 people yearly in the United States.

Medical tourism is common among people living in the United States., as patients try to find cheaper care abroad. Other U.S. residents travel abroad because they would rather seek care in their home country, according to the CDC.

“In 2007, it is estimated that 750,000 Americans traveled to other countries for health care,” researchers wrote in the American Journal of Medicine this month. “In 2017, more than 1.4 million Americans sought health care in a variety of countries around the world.”

But the risks aren’t well understood.

“[Medical tourism] is a rapidly growing market, and we have relatively little data on the extent of this practice,” said Dr. Doug Esposito, a medical epidemiologist with the CDC, according to Time magazine. “We need to understand the nature of the problem and the risks people might be experiencing.”

The CDC advises those planning medical tourism to see a travel medical practitioner a month or more before the trip, to inform their regular healthcare providers and to check the qualifications of the doctors who will be doing procedures on them. The CDC also recommends patients travel with details about their prescriptions and their medical records.